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Home My WebLink About283 Sullivan Avenue - Life Safety System (4) INSPECTION AND TESTING FORM WO#: 0142 DATEII/q/7 I SERVICE ORGANIZATION PROPERTY NAME(USER) NAME: Dynamark Security NAME: AMK Welding* ADDRESS: P.O.Box 1170 Tolland,CT 06084-1170 ADDRESS: 283 Sullivan Avenue REPRESENTATIVE: Michael G.Casieri South Windsor,CT 06074 LICENSE N6.: 181641 TELEPHONE: (860)289-5634 TELEPHONE: (860)872-4050 CONTACT: Konrad Boltruczyk CHECK HERE IF MAILING ADDRESS IS DIFFERENT❑ MONITORING ENTITY APPROVINGAGENCY CONl'ACT: CMS CONTACT: South Windsor Fire Marshal TELEPHONE: 1-866-229-7287 ADDRESS: 232 West Road,Fire House#3 South Windsor,CT 06074 MONTI ORING ACCOUNT#: FLRPS 1436 TELEPHONE: 860-282-0669 ext. 1 TYPE TRANSMISSION CE Lj-MiC�oh ❑-Weekly El-M i lex ❑-Monthly ®-Dil M ❑-Quarterly ❑-Re(erse Priority �-R F �-Semi-Annually. �-��(Specify) ®-Annually ❑-Other(Specify) PANETr MANUFACTURER:Silent Knight MODEL NO.:5207 DATE INSTALLED: 12/06 CIRCUIT STYLES:B NO. OF CIRCUITS: SOFT*ARE REV.: LAST DATE SYSTEM HAD ANY SERVICE PERFORMED: Fine Test 520/16,replied horn/strobe 5/31/16 ALARM INITIATING DEVICES AND CIRCUIT INFORMATION CKL STYLE 11 B MANUAL STATIO NS 11 B P HOTO DETECTORS 2 B DUCT DETECTORS HEAT DETECTORS WATERFLOW SWITCHES SUPERVISORY SWITCHES OTHER:(SPECIFY) i ALARM INDICATING APPLIANCES AND CIRCUIT INFORMATION Ty CKr.STYLE TYPE LOCATION VISUAL FUNCTIONAL I B - Strobe Rece tion Ladies'Room 1 B Strobe Rece tion Men's Room i B Horn/Strobe Reception East I B Horn/Strobe Original vifice I B Strobe Warehouse Ladies'Room I B Strobe Warehouse Men's Room 1 B Horn/Strobe Warehouse Above Bathroom Door 1 B Horn/Strobe Warehouse North Exit 1 B Horn/Strobe Warehouse East Exit I H Horn/Strobe Warehouse South Exit 1 B Horn/Strobe Sho Northeast Exit I B Horn/Strobe Shop Southeast Exit 1 B Horn/Strobe Shop Northwest Exit 1 B Horn/Strobe Shop North Center Exit 1 B Horn/Strobe on Cafe Exit I B Horn/Strobe Shot)Northeast Exit I B Horn/Strobe -Shop East Side I0 Partition I Horn/Strobe S hop Side 2° Partition I B HornI obe 2na Partition NO.OF ALARM INDICATING CIRCUITS:3 ARE CIRCUITS SUPERVISED? [3YES []NO POWER SUPPLIES . r Main :Nomtaai Volta e I20v Aurrent Protection.T e Breaker Location Panel Number �` la Disconnectin Means Location: Circuit#I b._Secondary(Standbv'): . Storage Batter #1: Am -Hr.Rating VDC: "I AH: Installed: 5 f'3 Story a Bane. #2: Amp-Hr,Rating: VDC.: - Ah: t Installed [261T$ TYPE BATTERY Sealed Dead-Acid PRIOR.TO ANY TESTING NOTIFICATIONS ARE iVIADE: NO i WHO T MONITORING ENTITY BUILDING OCCUPANTS BUILDING MANAOl,MENT OTHER SPECIFY AHJ OTIFIED OF ANY IMPAIRMENTS i ANN NCIATORS TYPE VISUAL FUNC�Front COMMENTS kM:OO-TEANNLTNCIATORS ® ntrance INITIATING AND SUPERVISORY DEVICE TESTS AND INSPECTIONS LOCATION DEVICE VISUAL FUNCTION PASS FAIL TYPE CHECK TEST Office Ad'. West Side Door Smoke Detector ® ❑ West Office/TelComm Room Smoke Detector ❑ File Storaga Smoke Detector ❑ Office/Conference Area Smoke Detector El Office Ri t of Main Ent. Smoke Detector ❑ ffice Left of Main Ent. Smoke Detector ece tion Left Smoke Detector ece tion Center Smoke Detector Itece tion Ri t Smoke Detector (conference Room Smoke Detector ®' ❑ esident's Office Smoke Detector ❑ $ho Northeast Exit Pull Station El Cafd Pull Station ❑ Slho. North-Center Exit Pull Station ❑ Sha Northwest Exit Pull Station ❑ o Southeast Exit Pull Station ❑ o Northeast Exit Pull Station Main Entrance Pull Station ❑ ❑ arehouse No rth Exit Pull Station � V$'arehouse East Exit Pull Station ❑ ❑ Warehouse South Exit Pull Station � ❑ est Side Exit Door Pull Station ❑ COMMENTS: DUAL DEVICE SIMULATED OPERATION OPERATION RFACE EQUIPMENT Remote;Annunciator (� SP � � ❑ SP -- ❑ SPECIAL PROCEDURES/COMMENTS/DEFICIENCIES: .. 'tea^ 1oZJ �Ad-1 �- ONfOFF PREMISES MONITORING 'YES NO TIME COMMENTS ALARM SIGNAL ALARM RESTORAL TROUBLE SIGNAL SUPERVISORY SIGNAL SUPERVISORY RESTORAL NOTIFICATION THAT THIS YES NO WHO TIME TESTING IS COMPLETE: BUILDING MANAGEMENT f �` MONITORING AGENCY BUILDING OCCUPANTS OTHER SPECIFY - THE FOLLOWING DID NOT OPERATE CORRECTLY: SYSTEM RESTORED TO NORMAL OPERATION: DATE $1 )17 TIME THIS TESTING WAS PERFORMED IN ACCORDANCE WITH APPLICABLE NFPA STANDARDS NAME OF INSPECTOR: v�17 t`-``l'" •�'£L DATE: '&I i—�I l 7 SIGNATURE: NAME OF OWNER OR REPRESENTATIVE: DATE: t SIGNATURE: